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Missouri rates for HCPCS 50684

Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$116.84 / $2,832.00 / $9,304.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.99 / $116.84 / $171.06
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$862.00 / $1,818.00 / $4,958.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.00 / $103.92 / $266.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.08 / $85.08 / $85.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $115.32 / $274.58
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.11 / $134.63 / $586.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.54 / $241.84 / $3,402.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.00 / $875.00 / $1,351.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.54 / $175.07 / $311.83